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目的分析重型肝炎的临床特点,重新探讨重型肝炎的临床诊断标准。方法使用SPASS软件和SDAS软件将我院近3年收治的565例重型肝炎患者的临床特点进行分析。结果①发生于急性肝炎的45例,发生于慢性的有明确的肝病史及无明确的肝病史分别为400例及120例。②9例急性重型肝炎,出现肝性脑病7例,均在7天内出现。36例亚急性及520例慢性重型肝炎患者,在12周内达到重型肝炎诊断标准分别为100. 0％及82. 2％。③急性重型肝炎发生的肝性脑病均为首先出现,无1例发生腹水。亚急性重型肝炎及慢性重型肝炎首先出现肝性脑病仅为11. 1％及1. 7％,仅发生腹水分别为5. 6％及3. 5％。④无明确肝病史的120例患者,最后诊断为慢性重型肝炎早、中及晚期分别为17例、31例及72例。结论①重型肝炎依发病基础分为急性重型肝炎(暴发性肝衰竭)、亚急性重型肝炎(亚暴发性肝衰竭)及慢性重型肝炎;②暴发性肝衰竭、亚暴发性肝衰竭的时限分别为14天内、15天至24周(半年);③亚急性重型肝炎分腹水型及脑病型;④亚急性重型肝炎及慢性重型肝炎仍应区分为早期、中期及晚期。
Objective To analyze the clinical features of severe hepatitis and revisit the clinical diagnostic criteria of severe hepatitis. Methods The clinical features of 565 patients with severe hepatitis treated in our hospital for nearly three years were analyzed using SPASS software and SDAS software. Results ① In 45 cases of acute hepatitis, there were 400 cases and 120 cases of chronic liver disease with clear history and no history of liver disease. ② 9 cases of acute severe hepatitis, hepatic encephalopathy appeared in 7 cases, all within 7 days. 0% 和 82. 2%. In 36 cases of subacute and 520 cases of chronic severe hepatitis, the diagnostic criteria for severe hepatitis reached 100.0% and 82.2% within 12 weeks respectively. ③ acute severe hepatitis hepatic encephalopathy are the first to occur, no case of ascites. 6% 及 3.5%. Ascites and chronic severe hepatitis first hepatic encephalopathy was only 11.1% and 1.7%, ascites were 5.6% and 3.5% respectively. ④ In the 120 patients without a definite history of liver disease, the final diagnosis was chronic early, middle and late, respectively, 17 cases, 31 cases and 72 cases. Conclusions ① According to the disease, severe hepatitis is divided into acute severe hepatitis (fulminant hepatic failure), subacute severe hepatitis (sub-fulminant hepatic failure) and chronic severe hepatitis. (2) The time of fulminant hepatic failure and sub-fulminant hepatic failure are 14 days, 15 days to 24 weeks (six months); ③ subacute severe ascites and encephalopathy; ④ subacute severe hepatitis and chronic severe hepatitis should still be divided into early, middle and late.